Computed axial tomography in C1-C2 trauma.

Twenty patients with C1-C2 vertebral trauma underwent computed tomographic (CT) scans to evaluate prospectively its efficiency for diagnosis and treatment. It is suggested that if standard roentgenograms are inconclusive, CT scan is recommended for further evaluation of C1 fractures and C1-C2 rotatory subluxation in preference to tomography and cineradiography. CT scans do not assess dynamic stability and may miss minimally displaced odontoid fractures. It was also concluded that they add little in the treatment of hangman's fractures, although scanning did show that the pathology was often more complex than anticipated. The clinician must be aware of the capabilities and the limitations of the specific scanner in use and work closely with the radiologist to maximize the yield of information. The CT scan is very helpful as an adjunct to standard x-ray studies, but is not recommended as a screening procedure.